RECEIVED PL STE

Transcription

1 IT C r C C r Form 990-EZ Department of the Treasury Internal Revenue Service Short Form OMB No Return of Organization Exempt From Income Tax Under section 501(c), 527, or 4947( a)(1) of the Internal Revenue Code (except black lung benefit trust or 2008 private foundation) in t f d d d f S ponsor g organiza ions o onor a vise un ds and controlling organizations as defined in section 512(bx13 ) must file Form 990 All other organizations with gross receipts less than $1,000, 000 and total assets less than $2,500, 000 at the and of the year may use this form Open to Public I BO, Theorganization ma y have to use a copy of this return to satis fy state reporting requirements. Inspection A For the 2008 calendar year, or tax year beginning and ending B applica le please C Name of organization D Employer identification number a Abddrtss use IRS label or Print or NORTHERN RHODE ISLAND CHAMBER FOUNDATION type Number and street (or P.O. box, if mail is not delivered to street address) Room/suite E Telephone number See E::A1 16 Initial return ^Termination Amended return Specific 6 BLACKSTONE VALLEY Instructions City or town, state or country, and ZIP + 4 F Group Exemption PL STE INCOLN RI Number jp^ Section 501 ( c)(3) organizations and 4947 ( a)(1) nonexempt charitable trusts must attach a completed G Accounting method: = Cash Accrual Schedule A ( Form 990 or 990-EZ ). Other (soeclfv) I Website : WWW. NRI CHAMBER. COM I H Check LXJ if the organization is not J Organization type (check only one) - 501(c) ( 3 ) 4 (insert no.) [ 4947(a)(1) or [] 527 required to attach Schedule B (Form 9ea 990-EZ or990-pf) K Check L2 if the organization is not a section 509(a )( 3) supporting organization and its gross receipts are normally not more than $25,000. A return is not required, but it the organization chooses to file a return, be sure to file a complete return. L Add lines 5b, 6b, and 7b, to line 9 to determine g ross recei p ts: if $ 1,000,000 or more, file Form 990 instead of Form 990-EZ go, $ 356. Part I Revenue, Expenses, and Changes in Net Assets or Fund Balances ( See the Instructions for Part l.) 1 Contributions, gifts, grants, and similar amounts received 1 2 Program service revenue including government fees and contracts 2 3 Membership dues and assessments 3 4 Investment income 4 5a Gross amount from sale of assets other than inventory 5a b Less: cost or other basis and sales expenses 5b c Gain or (loss) from sale of assets other than inventory (Subtract line 5b from line 5a) (attach schedule) 5c 6 Special events and activities (complete applicable parts of Schedule G). If any amount is from gaming check here, a Gross revenue (not including $ of contributions reported on line 1) 6a b Less: direct expenses other than fundraising expenses 6b c Net income or (loss) from special events and activities (Subtract line 6b from line 6a) 6c 7a Gross sales of inventory, less returns and allowances 7a b Less: cost of goods sold 7b c Gross profit or (loss) from sales of inventory (Subtract line 7b from line 7a) 7c 8 Other revenue (describe MISCELLANEOUS ) Total revenue. Add lines c, 6c, 7c, and 8 Oil Grants and similar amounts paid (attach schedule) 10 RECEIVED 11 Benefits paid to or for members 11 c 12 Salaries, other compensation, and employee benefits Professional fees and other payments to independent contractors CC) Q 13 4, 020. ro JUN K 14 Occupancy, rent, utilities, and maintenance U) 14 W 15 Printing, publications, postage, and shipping G^^^ u Other expenses (describe BANK FEES Total exp enses. Add lines 10 throug h 16 No. 17 4, Excess or (deficit) for the year (Subtract line 17 from line 9) 18-3, 712. e 19 Net assets or fund balances at beginning of year (from line 27, column (A)), (must agree with end-of-year figure reported on prior year's return) 19 3, 801. Z 20 Other changes in net assets or fund balances (attach explanation) Net assets or fund balances at end of year. Combine lines 18 throw h 20 Poo, Part II Balance Sheets. If Total assets on line 25, column (B) are $2,500,000 or more, file Form 990 instead of Form 9 90-EZ. (See the instructions for Part II.) (A) Beginning of year (B) End of year 22 Cash, savings, and investments 3, Land and buildings Other assets (describe Do Total assets 3, Total liabilities (describe ) Net assets or fund balances ( line 27 of column ( B ) must a g ree with line 21 ) 3, oe LHA For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Form 990-EZ (2

2 Form 990 -EZ (20 08) NORTHERN RHODE ISLAND CHAMBER FOUNDATION Page 2 Part III Statement of Program Service Accomplishments (See the instructions for Part III.) Expenses What is the organization's primary exempt purpose? (Required for 53) and (4) organizations and Describe what was achieved in carrying out the organization's exempt purposes. In a clear and concise manner, describe the services 4947(a)(1) trusts; optional provided,.the number of persons benefited, or other relevant information for each program title. for others.) Grants $ If this amount includes foreig n rants check here 00, 0 28a 30 Grants $ If this amount includes foreig n g rants, check here 0 29a Grants $ If this amount includes foreig n rants check here 00- El 30a 31 Other program services (attach schedule) Grants $ If this amount includes foreig n rants check here El 31a 32 Total program service exp enses ( add lines 28a through 31a ) 32 0 Part IV I List of Officers, Directors, Trustees, and Key Employees. List each one even if not compensated (See the instructions for Part IV) (a) Name and address b) Title and average hours ( per week devoted to position (c) Compensation () (If not paid, enter -0-.) t (dens to employee benefit plans & deferred compensation (e) Expense account and other allowances ROBERT ANDRADE, PCU, 1200 CENTRAL SECRETARY STREET PAWTIUCKET, RI BARBARA GREGORY, BRYANT UNIVERSITY, BOARD MEMBER 1150 DOUGLAS PIKE, SMITHFIELD, RI WILLIAM HUNT, SHOVE INSURANCE, 100 BOARD MEMBER - EAST AVE PAWTIUCKET, RI PAUL D. FRECHETTE, BATCHELOR TREASURER - FRECHETTE, MCCRORY MICHAELS, H. ANTHONY DELLER 301 METRO CENTER CHAIRMAN BLVD SUITE 302, WARWICK, RI e2-17-0s Form 990-EZ (2008)

3 Form 990-EZ Part v I Other information (Note the statement renwrements in the instructions for Part VIA 33 Did the organization engage in any activity not previously reported to the IRS? If 'Yes,' attach a detailed description of each activity 34 Were any changes made to the organizing or governing documents but not reported to the IRS? If "Yes," attach a conformed copy of the changes 35 If the organization had income from business activities, such as those reported on lines 2, 6a, and 7a (among others), but not a reported on Form 990-T, attach a statement explaining your reason for not reporting the income on Form 990-T. Did the organization have unrelated business gross income of $1,000 or more or section 6033(e) notice, reporting, and proxy tax requirements? b If 'Yes; has it filed a tax return on Form 990 -T for this year? 36 Was there a liquidation, dissolution, termination, or substantial contraction during the year? If 'Yes; complete applicable parts of Sch. N 37a Enter amount of political expenditures, direct or indirect, as described in the instructions. ^ 37a 38a b Did the organization file Form POL for this year? Did the organization borrow from, or make any loans to, any officer, director, trustee, or key employee or were any such loans made in a prior year and still unpaid at the start of the period covered by this return? b If'Yes; complete Schedule L, Part II and enter the total amount involved 38b N / A 39 Section 501(c)(7) organizations. Enter: a Initiation fees and capital contributions included on line 9 39a N / A b Gross receipts, included on line 9, for public use of club facilities 39b N A 408 Section 501(c)(3) organizations. Enter amount of tax imposed on the organization during the year under: section ; section ; section b Section 501(c)(3) and (4) organizations. Did the organization engage in any section 4958 excess benefit transaction during the year or did it become aware of an excess benefit transaction from a prior year? If 'Yes,' complete Schedule L, Part I c Enter amount of tax imposed on organization managers or disqualified persons during the year under sections 4912, 4955, and d Enter amount of tax on line 40c reimbursed by the organization 0. e All organizations. At any time during the tax year, was the organization a party to a prohibited tax shelter transaction? If 'Yes,' complete Form 8886-T 40e X 41 List the states with which a copy of this return is filed. RI 42a The books are in care of RACHEL SAN ANT INI O Telephone no Located at 6 BLACKSTONE VALLEY PLACE #301, LINCOLN, RI ZIP b At any time during the calendar year, did the organization have an interest in or a signature or other authority over a financial account in a foreign country (such as a bank account, securities account, or other financial account)? If 'Yes,' enter the name of the foreign country. See the instructions for exceptions and filing requirements for Form TD F , Report of Foreign Bank and Financial Accounts. At any time during the calendar year, did the organization maintain an office outside of the U.S.? If 'Yes, enter the name of the foreign country: 43 Section 4947(a)(1) nonexempt charitable trusts filing Form 990-EZ in lieu of Form Check here and enter the amount of tax-exempt interest received or accrued during the tax year 42b 42c I 43 I N/A Yes X X No X X 0 44 Did the organization maintain any donor advised funds? If 'Yes; Form 990 must be completed instead of Form 990-EZ 45 Is any related organization a controlled entity of the organization within the meaning of section 512(b)(13)? If 'Yes,' Form 990 must be Form 990-EZ (2008)

4 Form 990-EZ (2008) NORTHERN RHODE ISLAND CHAMBER FOUNDATION Page 4 Part VI Section 501 (c)(3) organizations only. All section 501 (c)(3) organizations must answer questions and complete the - tables for lines 50 and Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public Yes No office' If "Yes," complete Schedule C, Part I 46 X 47 Did the organization engage in lobbying activities? If "Yes," complete Schedule C, Part II 47 X 48 Is the organization operating a school as described in section 170(b)(1)(A)(iQ7 If "Yes," complete Schedule E 48 X 49a Did the organization make any transfers to an exempt non-charitable related organization? 49a X b If "Yes," was the related organization(s) a section 527 organization's 49b 50 Complete this table for the five highest compensated employees (other than officers, directors, trustees and key employees) who each received more than $100,000 of compensation from the organization. If there is none, enter 'None.' (a) Name and address of each employee paid more than $100,000 NONE (b) Title and average hours per week devoted to position (c) Compensation (D) Contributions to employee benefit plans & deferred compensation (E) Expense account and other allowances Total number of other em p loyees paid over $100, Complete this table for the five highest compensated independent contractors who each received more than $100,000 of compensation from the organization If there is none, enter "None."

5 SCHEDULE A (Form 990 or 990-E2) Public Charity Status and Public Support To be completed by all section 501(c)(3) organizations and section 4947(a)(1) nonexempt charitable trusts. Department of the Treasury Internal Revenue Service 110- Attach to Form 990 or Form 990-EZ. See separate instructions. OMB No Open to Public Inspection Name of the organization I Employer identification number WnRTRFRN RHr)nV. T CT.A1TT1 f`tlmrf!1^ Wr)T7TTT TnM 7 7 _) 01 APO) rt I_1 Reason Tor I udllc charity status (All organizations must complete this part.) (see instructions) The organization is not a private foundation because it is: (Please check only one organization.) I El A church, convention of churches, or association of churches described in section 170 (b)(1)(a)(i). 2 A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.) 3 0 A hospital or a cooperative hospital service organization described in section 170 ( b)(1)(a)(iii). (Attach Schedule H.) 4 0 A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state: 5 El An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170 ( b)(1)(a)(iv ). (Complete Part II.) 6 0 A federal, state, or local government or governmental unit described in section 170 (b)(1)(a)(v). 7 An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170 (b)(1)(a)(vi). (Complete Part II.) 8 El A community trust described in section 170( b)(1)(a)(vi ). (Complete Part II.) 9 El An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions - subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, See section 509(a )(2). (Complete the Part III.) 10 O An organization organized and operated exclusively to test for public safety. See section 509(a )(4). (see instructions) 11 El An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a )(2). See section 509(a )(3). Check the box that describes the type of supporting organization and complete lines Ile through 11h. a El Type I b 0 Type II c El Type III - Functionally integrated d 0 Type III - Other e 0 By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509 (a)(1) or section 509(a)(2). f If the organization received a written determination from the IRS that it is a Type I, Type II, or Type III supporting organization, check this box El g Since August 17, 2006, has the organization accepted any g ift or contribution from any of the following persons? h ( i) A person who directly or indirectly controls, either alone or together with persons described in (1) and ( iii) below, Yes No the governing body of the supported organization? 11 i (ii) A family member of a person described in (I) above? 11 ii (iii) A 35% controlled entity of a person described in (I) or (i) above? iii Provide the following information about the organizations the organization supports. (i) Name of supported organization (ii) EIN (iii) Type of (iv) Is the organization organization ) () v Did you notify the n col. (1) listed in your organization in col. organization In col. (described on lines 1-9 governing (1) organized in the document? (i) of your support? above or IRC section U.S.? (see instructions )) Yes No Yes No Yes No (vii) Amount of support Total LHA For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule A (Form 990 or 990-EZ)

6 Schedule A (Form 990 or 990 -EZ) 2008 NORTHERN RHODE ISLAND CHAMBER FOUNDAT I ON Pag e 2 Part II Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) -(Complete only if you checked the box on line 5, 7, or 8 of Part I.) Section A. Public Support Calendar year (or fiscal year beginning (a) 2004 (b) 2005 (c) 2006 ( d ) 2007 a 2008 Total 1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants."). 56, , , Tax revenues levied for the organization's benefit and either paid to or expended on its behalf 3 The value of services or facilities furnished by a governmental unit to the organization without charge 4 Total. Add lines , , , The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) 6 Public Support. Subtract line 5 from line a Section B. Total Support Calendar year (or fiscal year beginning in)'- 7 Amounts from line 4 8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources 9 Net income from unrelated business activities, whether or not the business is regularly carried on 10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) Total support. Add lines 7 through 10 Gross receipts from related activities, etc. (see instructions) 13 First five years. If the Form 990 is for the organization 's first, second, third, fourth, or fifth tax year as a section 501 (c)(3) section c:. computation OT ruoilc support Percentage (a ) 2004 (b ) 2005 (c) (02008 Total , , Public support percentage for 2008 (line 6, column (f) divided by line 11, column (f)) % 15 Public support percentage from 2007 Schedule A, Part IV-A, line 26f % 16a 33 1 /3% support test If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box and stop here. The organization qualifies as a publicly supported organization. b 33 1/3% support test If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this box and stop here. The organization qualifies as a publicly supported organization = 17a 10% -facts - and-circumstances test If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part IV how the organization meets the "facts-and-circumstances " test. The organization qualifies as a publicly supported organization..,,,,. b 10% -facts -and-circumstances test If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization 60, Private foundation. If the organization did not check a box on line 13, 16a, 16b, 7a, or 17b, check this box and see instructions 0 LI Schedule A (Form 990 or 990-EZ)

7 Schedule A ( Form 990 or 990-EZ) 2008 Pag e 3 Part III Support Schedule for Organizations Described in Section 509(a)(2) (Complete only if you checked the box on line 9 of Part l.) Section A: Public Support Calendar year (or fiscal year beginning (a ) 2004 (b) 2005 c 2006 (d ) 2007 (e) 2008 Total 1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") 2 Gross receipts from admissions, merchandise sold or services performed, or facilities fumished in any activity that is related to the organization's tax-exempt purpose 3 Gross receipts from activities that are not an unrelated trade or business under section Tax revenues levied for the organization's benefit and either paid to or expended on its behalf 5 The value of services or facilities fumished by a governmental unit to the organization without charge 6 Total. Add lines 1-5 7a Amounts included on lines 1, 2, and 3 received from disqualified persons b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of 1% of the total of lines 9, 10c, 11, and 12 for the year or $5,000 c Add lines 7a and 7b 8 Public su pport ( subtrac;line 7c from line 6 ) Section B. Total Support Calendar year (or fiscal year beginning (a) 2004 b 2005 c 2006 (d ) 2007 (e ) 2008 Total 9 Amounts from line a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975 c Add lines 1 Oa and 1 Ob 11 Net income from unrelated business activities not included in line 1 Ob, whether or not the business is regularly carried on 12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) - 13 Total support (Add lines 9, 10c, 11, and First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501 (c)(3) organization, check this box and stop here Section C. Comoutation of Public Sunnort Percentage ci Section D. Computation of Investme nt Income Percentage 17 Investment income percentage for 2008 (line 10c, column (f) divided by line 13, column (f)) 17 % 18 Investment income percentage from 2007 Schedule A, Part IV-A, line 27h 18 % 19a 33 1/3% support tests If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization... 0 b 33 1/3% support tests If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3%, and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization, LI 20 Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions El Schedule A (Form 990 or 990 -F2)

8 'NORTHERN RHODE ISLAND CHAMBER FOUNDATION FORM 990-EZ INFORMATION REGARDING TRANSFERS STATEMENT 1 ASSOCIATED WITH PERSONAL BENEFIT CONTRACTS A) DID THE ORGANIZATION, DURING THE YEAR, RECEIVE ANY FUNDS, DIRECTLY OR INDIRECTLY, TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT? [ ] YES [X] NO B) DID THE ORGANIZATION, DURING THE YEAR, PAY PREMIUMS, DIRECTLY OR INDIRECTLY, ON A PERSONAL BENEFIT CONTRACT?.. [ ] YES [X] NO STATEMENT(S) 1

9 Form 8868 I Application for Extension of Time To File an (Rev. April 2009) I Exempt Organization Return OMB No Department of the Treasury Internal aevenve service File a separate application for each return. If you are filing for an Automatic 3-Month Extension, complete only Part I and check this box FT If you are filing for an Additional (Not Automatic) 3-Month Extension, complete only Part II (on page 2 of this form). Do not complete Part li unless you have already been granted an automatic 3-month extension on a previously filed Form Fart Automatic 3-Month Extension of Time. Only submit original (no copies needed). A corporation required to file Form 990-T and requesting an automatic 6-month extension check this box and complete Part I only El All other corporations (including 1120-C filers), partnerships, REMICs, and trusts must use Form 7004 to request an extension of time to file income tax returns. Electronic Filing (e-file). Generally, you can electronically file Form 8868 if you want a 3-month automatic extension of time to file one of the returns noted below (6 months for a corporation required to file Form 990-T). However, you cannot file Form 8868 electronically if (1) you want the additional (not automatic) 3-month extension or (2) you file Forms 990-BL, 6069, or 8870, group returns, or a composite or consolidated Form 990-T. Instead, you must submit the fully completed and signed page 2 (Part II) of Form For more details on the electronic filing of this form, visit ov/efile and click on e-file for Charities & Non profits, Type or Name of Exempt Organization Employer identification number print File by the due date for NORTHERN RHODE ISLAND CHAMBER FOUNDATION Number, street, and room or suite no. If a P.O. box, see instructions. filing your 6 BLACKSTONE VALLEY PL STE 105 return See Instructions City, town or post office, state, and ZIP code. For a foreign address, see instructions. LINCOLN, RI Check type of return to be filed (file a separate application for each return): OX Form Form 990-T (corporation) 0 Form 4720 Q Form 990-BL El Form 990-T (sec. 401(a) or 408(a) trust) El Form 5227 Q Form 990-EZ 0 Form 990-T (trust other than above) El Form 6069 Form 990-PF 0 Form 1041-A 0 Form 8870 RACHEL SAN ANTINIO The books are inthecareof 6 BLACKSTONE VALLEY PLACE #301 - LINCOLN, RI Telephone No FAX No. If the organization does not have an office or place of business in the United States, check this box.. 0 If this is for a Group Return, enter the organization 's four digit Group Exemption Number (GEN). If this is for the whole group, check this box =. If it is for part of the group, check this box El and attach a list with the names and EINs of all members the extension will cover. 1 I request an automatic 3-month (6-months for a corporation required to file Form 990-T) extension of time until AUGUST 15, 2009, to file the exempt organization return for the organization named above. The extension is for the organization's return for: X calendar year or 0 tax year beginning, and ending 2 If this tax year is for less than 12 months, check reason : 0 Initial return E] Final return 0 Change in accounting period 3a If this application is for Form 990-BL, 990-PF, 990-T, 4720, or 6069, enter the tentative tax, less any b If this application is for Form 990-PF or 990-T, enter any refundable credits and estimated c Balance Due. Subtract line 3b from line 3a. Include your payment with this form, or, if required, deposit with FTD coupon or, if required, by using EFTPS (Electronic Federal Tax Payment System). N/A Caution. If you are going to make an electronic fund withdrawal with this Form 8868, see Form 8453-EO and Form 8879-EO for payment instructions. > For Privacy Act and Paperwork Reduction Act Notice, see Instructions. Form 8868 (Rev ) P